CT辅助髁突矢状骨折手术治疗的实验研究

Experimental study on open treatment of sagittal fracture of the mandibular condylar assisted by CT

目的:研究CT辅助设计和测量在髁突矢状骨折(SFMC)手术治疗中的应用价值。方法:4只绵羊被制备成SFMC动物模型,分别在截骨术前、切开复位内固定(ORIF)手术前后行颞下颌关节(TMJ)CT扫描。应用Mimics8.1软件设计并测量截骨术前、ORIF术前侧向螺钉钉道的位置和长度,与术中实际制备和测量的钉道长度以及ORIF术后CT测量的侧向螺钉长度进行比较,以SPSS12.0软件包中的两样本t检验和配对t检验对数据进行统计学分析。结果:截骨术前与ORIF术前CT设计、测量的钉道长度无显著差异(P=0.751),ORIF术前CT设计、测量的钉道长度与术中实际测量的钉道长度无显著差异(P=0.564),ORIF术后CT测量的螺钉长度与术中实际测量的钉道长度无显著差异(P=0.323)。结论:利用螺旋CT可以在SFMCORIF手术治疗前预测侧向螺钉的钉道长度,为术前选择侧向螺钉的长度和术中准确制备合适的侧向螺钉钉道以及防止意外损伤提供帮助。

PURPOSE： To evaluate the role of application of CT before open treatment of sagittal fracture of the mandibular condyle （SFMC）. METHODS： SFMC models were created in sheep through osteotomy. The temporomandibular joint （TMJ） CT data scanned before osteotomy, before and after open reduction and internal fixation （ORIF） were imported into the software of Mimics8.1. The lengths of trajectories of lateral screws before osteotomy and ORIF, and the length of lateral screws after ORIF were obtained. The length of trajectories of lateral screws was measured intraoperatively. The results were analyzed by two-sample t-test and paired t-test using SPSS 12.0 Software package. RESULTS： There was no significant different between before osteotomy and before ORIF （P=0.751）. There was no significant different between before ORIF and intraoperatively （P=0.564）. There was no significant different between after ORIF and intraoperatively（P=0.323）. CONCLUSIONS： Although the fragment was displaced, it demonstrated that the length of trajectories of lateral screws measured using CT was accurate. It is helpful to choose the length of lateral screws preoperatively and drill appropriate trajectories of lateral screws accurately and prevent unnecessary injuries intraoperatively.